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Prevalence of MDR-XDR TB at a tertiary care hospital in Pune, India: 2015-2016 a retrospective study

Paranjpe, Tejas (2018) Prevalence of MDR-XDR TB at a tertiary care hospital in Pune, India: 2015-2016 a retrospective study. Master Essay, University of Pittsburgh.

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Abstract

The tuberculosis (TB) epidemic is one of the biggest public health challenges in the world today. One of the top 10 causes of death worldwide, TB has caused an estimated 1.4 million deaths in 2015. Recently, the emergence of multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant (XDR-TB) has alarmed public health officials, as it significantly hampers effective TB control. MDR and XDR-TB cases present a significant infectious disease burden in developing countries as they require a substantially longer time to treat than drug-susceptible TB. Furthermore, they entail the need for second-line injectable anti-TB drugs, which are more expensive, have more severe side-effects and require a more intense regimen of patient observation. The World Health Organization (WHO) in 2015 estimated that out of 1,740,435 notified cases in India, 28 876 were MDR/RR-TB and 3 048 were XDR-TB, representing a significant global burden of drug resistant TB. This problem is further compounded by the paucity of TB monitoring in large tertiary care hospitals in India where most patients go to seek treatment. A study was carried out to examine prevalence of drug resistance amongst all TB cases presented to a large urban tertiary care hospital in Pune, India, to document patterns in first-and second-line drug susceptibility for suspected MDR and XDR cases and inspect drug resistance in the two clinical manifestations of TB: pulmonary and extra pulmonary. The retrospective analysis showed a high prevalence of MDR and XDR in confirmed cases (41%), with XDR-TB taking up a larger proportion (59%). No monoresistant cases were observed in the data set analyzed. INH+RIF+EMB+SM had the largest proportion (41%) of first-line drug resistance in suspected MDR-TB cases. The highest proportion of resistance to second-line drugs was seen in FQ+Amk (50%). Lastly, pulmonary TB (PTB) was more prevalent than Extrapulmonary TB (EPTB); though XDR-TB was more prevalent in EPTB; correlating with global patterns of resistance.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Paranjpe, Tejastep10@pitt.edutep10
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairMartinson, Jeremyjmartins@pitt.edujmartinsUNSPECIFIED
Committee MemberTerry, Marthamaterry@pitt.edumaterryUNSPECIFIED
Date: 16 May 2018
Date Type: Submission
Number of Pages: 38
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 01 Jun 2019 00:06
Last Modified: 26 Aug 2019 15:25
URI: http://d-scholarship.pitt.edu/id/eprint/34329

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